Ellen Roth, LCSW R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R0361531 Issued in NY

Practice address

20 Squadron Boulevard #560
Dr Mark Tarle
New City, NY 10956

Phone

(845) 639-3150

Fax

(845) 639-0727

NPI assigned

Nov 27, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326114992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 GEDNEY STREET",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109602208",
            "telephone_number": "845-358-0044",
            "fax_number": "845-358-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SQUADRON BOULEVARD #560",
            "address_2": "DR MARK TARLE",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "10956",
            "telephone_number": "845-639-3150",
            "fax_number": "845-639-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "ELLEN",
        "credential": "LCSW R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0361531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02275318",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melvin Seymour Rosh, M.D.
• Leonard Bernard Rosofsky, OPTICIAN
• Carolyn Ross
• Elizabeth Ross, PT
• David Andrew Rossi, PMHNP-BC
• Jane B. Roth, M.S.W., L.C.S.W.
• Tzipora Rothschild
• Debra Rothstein, M.S.
• Michael Rothstein, D.D.S.
• Jamie A. Rower

• Clinical Social Worker in New City, NY
• Providers in New City, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.